Q&A: Do I Need Another Endoscopy?

I have GERD as well as chronic anemia for which I take iron. My symptoms have been stable, however recently I experienced worsening in my symptoms, as well as dark stools. I last had an endoscopy a few years ago and everything was OK. Do I need another one?

There are many reasons why you may be having a worsening of your reflux symptoms, most commonly would be esophagitis. Perhaps there have been dietary indiscretions, or perhaps you need to be started on reflux medications, or have them adjusted if you are already on them. The dark stools can be dietary as well, or may be related to the iron.

That being said, further evaluation is required. While iron or certain foods can make the stool dark, they will not cause them to test positive for blood, so stool hemoccults should be checked. You should have blood work to see if your anemia has worsened. If there is worsening anemia or blood in the stool, then a repeat evaluation of your gastrointestinal tract is required. This should include an upper GI endoscopy, and if no explanation is found, a colonoscopy as well, as bleeding from the colon can cause dark stools as well. If no source is found on both the upper and lower exams, then a small bowel evaluation with either a small bowel series or small bowel capsule endoscopy may be indicated as well. You should check with your doctor to see what time of work up is planned.